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tv   Washington Journal Primetime COVID-19 Excess Deaths  CSPAN  May 7, 2020 8:00pm-9:06pm EDT

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journal" program or through our social media. america's cable television company. as a public service. brought to you by your television provider. ♪ >> washington journal primetime. for the next hour, a special evening edition. your questions and comments about the coronavirus epidemic start now. host: another 3 million americans have filed for unemployment benefits, with the labor department tomorrow expected to release a jobless report that could potentially hover around 20%. 5 one economist put it, 1 in jobs lost in seven weeks. it is thursday, may 7. on the washington journal, the death toll from coronavirus in this country has now passed 75,000. more than 1.2 million cases
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around the country. so when is it safe to reopen our economy? one leading medical expert joining us from boston in a moment. could there be a second wave? we will talk to an infectious disease doctor in the second half of the program. our phone lines are open. if you are a medical professional or medical student, 202-748-8002. we begin with the numbers from john hopkins university. now around the world 3.8 million cases of coronavirus. the death toll is now expected to surpass 267,000. joining us from boston is dr. jeremy faust an emergency room physician at brigham & women's hospital. thank you for being with us. we want to begin with your op ed in the washington post with this
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headline "the metric that could tell us when it is safe to reemerge." what is that metric? dr. faust: the metric that has been discussed the least but matters the most is what is called excess mortality, or excess deaths. that is simply the number of people who are dying in comparison to the usual rates we know about. for over 100 years we have been really good about keeping track of how many americans die every week, every year, from all causes -- heart attacks, cancer, old age. the numbers are remarkably stable. we know that. it is a credit to the epidemiologists of the past and present that we know that. what has occurred in the past month is unprecedented in recent decades. we are seeing a gigantic spike in certain areas of the country in deaths total. we know the reason for that is
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covid-19. the more important is the sheer numbers tells us this is having an outlandish effect compared to a bad flu season or something else. that is the point. if you track the complete number of deaths, you know how real that is. once this goes away, we may have had a handle on that. host: here is how you frame the argument. "excess mortality does not depend on counting the number of covid-19 deaths, which ultimately relies on the subjective opinion of physicians and medical examiners proffering on their best guess is. -- guesses. graphs that track the months and years, generations blend into the next. there is an unusual rise in deaths. it tapers off by the end of the century. then there is a sudden spike in new york and new jersey in september 2001. mostly the death count drones on
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with the march of time without much deviation and without fail." was sittingeah, i at my laptop writing that. it occurred to me this is an important moment in the history of our species. we have to acknowledge that. excess mortality is a terrifying opportunity for us to see that and respond accordingly. it is on one hand a scary moment, and on the other it is a lightbulb to say we can track safe,nd know if we're when we are safe. at some point, if we have been safe for long enough, if we can relax. host: that seems to be this question -- the question at this phase of the pandemic. how do you strike the balance between public safety, personal safety, and beginning to reestablish an economy that has basically been shut for the last
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seven weeks with more than 30 million americans now out of work? dr. faust: it is a very difficult problem our leaders face. think would say is i historians will look back on this time and will wonder what we knew when we decided to proceed with reopening the economy in this particular moment. i imagine would like to know that we knew the extent of the excess mortality. yes, we knew that. but it was determined that other things mattered more. what i am not really hearing -- and it could be the case -- is the argument citing if we stay closed -- saying if we stay closed for too long, it could cause starvation and deaths. stay enclosed has caused a
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decrease in the normal care. there are fewer heart attacks being diagnosed. the number of deaths occurring because of that is a tiny fraction compared to covid. reopeninge is we are the economy without really having done a very careful analysis in saying, well, what are we risking here? how many lives are going to be cost by this strategy? i think that is a hard balance to find. i don't have a sense that is the question anyone is seriously asking. host: what are you seeing as an er doctor? what is coming to the hospital today? dr. faust: here in massachusetts, every day is a different day. it is so random. that is the life of an emergency dr.. that is why i love my job. you never have the same day
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twice. there were days i did not love it as much because it was less reassurance and more trying to keep people alive. in the er we are proud that we save lives here and there. there were times we were seeing an extraordinary number of sick people. overall our volumes were down because people were afraid to come in. that will crop up over time, the effect of that. i don't think we see that yet. the number of icu patients was off the charts for us. we were able to expand in time in massachusetts. we were way over our capacity in the intensive care unit, but fortunately developed good policy to expand in time. now we are seeing a drop off in that, but it is so random because you could have a spike tomorrow. if it went through one or two nursing homes that hadn't been
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exposed yet, you could have a hundred more cases, and of those, 50 are in the icu and die, whereas a bunch of students get together and got it, you might have a few bad cases, but capacity would not feel it in the same way. it is beginning to feel right now like a lull, but i look at the numbers on paper and i know we are nowhere out of this. i can't say that with any confidence. host: i preface this question, you are a physician, not a hospital administrator. but how are hospitals dealing with this? they don't have elective surgery. they have patients who are quite ill, many who can't afford to pay the bills when they leave the hospital. dr. faust: the hospital administrators -- we get daily updates. they know the number one thing that matters is getting through this crisis. i am sure in the back of
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someone's mind is how we will stay in business. i have heard people, not locally, but nationally talk about what it would take to get the hospitals through this because of the revenue stream issues you brought up. my sense is they have been laser focused on the problems at hand. that said, we have to use this moment to take stock of how we do things. ways --em is in many not broken -- not adequate. we see this crisis affect the poor and minority communities. why? because they have undiagnosed medical conditions like diabetes and high blood pressure. this virus hurts them harder. we look at this problem and say how can we get through it? what can we learn about it? i don't want to be mr. pessimistic the entire hour, but
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the one silver lining we will have to look for is what do we learn? what does this experience teach us about how we have done public health until now? if we look inward at that and learn about ourselves, that could save lives. it could be that, in the final analysis years from now, what we have done today could save more lives than we ever lost. that depends on how many lives we save now and how much we learn. host: in a recent op-ed, you say there is no way to compare covid-19 to the seasonal flu. two very different viruses. coronavirus far more serious. dr. faust: correct. the thought there was people, for whatever reason -- seasonal influenza is the benchmark. it is the baseline upon which we make comparisons for infectious
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diseases. it is something people have heard of. the problem is these statistics accepted by my fellow physicians and the public about how many deaths there are per year by influenza are estimates determined by complicated algorithms by the cdc. these methodologies have been used for years. they are accepted as dogma. the problem with it is it would seem to suggest that 60,000 or so deaths per year can be attributed to influenza. that is about the same number of deaths per year as opioids and and motorlence vehicle safety collisions. hadalized i unfortunately to tell many families that their loved one had died because of
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those other things, but i couldn't remember any time where i did that with the flu. it was not just because i am an er dr. -- i get told that about any patient i have. it is that the cdc estimates seem to overstate the case. we are counting covid deaths by one by one. we are estimating flu deaths. we are seeing today those estimates may not have been as accurate as we were led to believe. comparing pure counts, it seems coronavirus is killing, per week, 20 times more americans than seasonal flu does during its worst week of the year. average, covidn is 20 times worse. when we get better data, it will be higher than that, but i can substantiate that. what i can say is 20 times worse
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does agree with what we are seeing on the ground. i don't remember seeing anything like this. i looked at elmhurst hospital in queens as a resident physician, the epicenter of this crisis in new york and therefore the country. none of us had seen that. for peopleberculosis coming from africa. the fact that people say it is the flu, similar death counts -- i found that rationale to be dangerous because it is falsely reassuring. host: dr. jeremy faust is an emergency room physician joining us on this thursday. you are on the air. good evening. it takes a few weeks for a test to be counted, and it could be off by a couple thousands. how accurate are these death tolls? host: thank you.
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how accurate are these tests? dr. faust: the death tolls do lag a bit. it depends state-by-state. the cdc is the slowest, because they have the responsibility to aggregate everything. when we see, for example, the cdc will publish the provisional daily counts of coronavirus and say it is as of yesterday, what is remarkable is that is incomplete data. you will see yesterday the total number of deaths as of may 5 looks like it was lower than it was last year. day we because after one only have a certain number of precincts reporting, so to speak. even in that context we have a dozen states reporting excess mortality this early. in a week or two when the lag catches up, we will then see how
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many states report excess mortality. there is a bit of a lag, but not so much that we can't figure out where we are. if you find a one you are already over, you are in an unusual situation, which is where we find ourselves today in the country. host: the next caller is from oakland, california. we talk about it, we tend to say there are black and browns that are dying. there would be a different take if you say it the other way, deathsx out of 10 virus are white. it was considered something that -- if it was something that is considered attacking them, they would take it more serious as compared to minorities. that is not the issue. americans are dying, but i think
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they would treat it more seriously if it were racialized the other way. six out of 10 white people are dying. host: we will get a response. dr. faust: i understand the caller's point of view. it is unfortunate we live in a society where people care about which race dies more than the next. inm sure that is true certain sections of the country. we have a historical legacy to deal with. i think people in general, in my experience, they identify with people that look like them and from their community. what concerns me is even though 70,000 people is an extraordinarily high number of deaths, it is not enough so that the average american knows one
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person who died of it. to get to that place, he would have to have -- you would have to have a half million deaths. to her point, how do you make it real? unfortunately it is what the eye sees. people say i don't see anyone dying, it is not so bad -- outside the hot zones. inside the hot zones they understand it. the socialeason is determinants of health is a major driver of these differences. it is not a genetic thing. it is nothrase is your genetic code that determines your outcome, it is your zip code. it is a call to action for all our communities. we have to have undiagnosed
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hypertension diagnosed so that when this happens, the same people that continuously get hit hardest are once again disproportionately impacted. an er you are a podcast host? dr. faust: yeah, the past six or seven years i had a podcast i do with my colleagues and another er doctor. ands for doctors and nurses other professionals. we try to bridge the old and the new. in the past months we went to all covid all the time. i started a blog about front-line workers and research experts. our research director is a physician and lawyer. our research editor is a johns hopkins resident physician, an
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unbelievably bright young doctor. we try to package the latest news from the perspective of a frontline dr. but make it readable for the public. we thought we would feel some -- fill some gaps. host: you are on with dr. jeremy faust in boston tonight. caller: am i still protecting myself by staying in? i heard that in new york some of the people that died from covid-19 stayed in. governor --as the the number governor cuomo said yesterday, people stayed home yet still contracted covid-19. dr. faust: it is a difficult question. i don't want to give advice on what the caller should do.
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listen to public health advisors at the local level. there is a greater point to be drawn from the question. different is very from any other virus we ever encountered, which is that it spreads even in patients who don't yet have symptoms, asymptomatic patients. that is an unusual circumstance. we get sick and we know it because of the cost and the fever. we feel crummy. we self-isolate all the time. we stay home from work. if you think of the evolution of that, i talked to a colleague of mine at yale. not only are these immune responses sort of a crude immunological site -- fight, it has a population benefit.
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it tells the world, stay away from me, i am sick right now. this virus exploits that assumption because it doesn't make everybody feel sick, so people go out and spread it. that is what makes this virus different. not many do that and also seem to kill 1% of the people it comes into contact with. that is what makes this virus a once in a century pathogen. host: why in so many cases severe chest pains, respiratory conditions with coronavirus? dr. faust: we are trying to unpack a bigger question that relates, as far as the virus that causes covid-19, is this particular virus special or different? does it have something on a body physiology level that is truly
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different than the usual, or is it viral sepsis? that means the virus makes your body fight and fight and your own immune system turns on itself. you are causing organ damage to your own tissues. it is important to know. we have not experienced a viral pathogen like this in a long time to know what it looks like when a virus like this goes across a population who has never seen it before. has seenely humanity this before. virus camekind of across and it wreaks havoc. it is unclear if there is something special about this pathogen or whether it has been a long time since we have seen unbridled attack on a body that doesn't have any kind of immunity. we will in a few years.
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host: our guest is dr. jeremy faust. he is on twitter. he is an er physician at brigham & women's hospital, also an instructor at harvard medical center. richard in washington. good evening. caller: a few minutes ago dr. faust was asked about reopening the economy and made the assumption that the economy should be reopened only if the excess deaths that would be c covid-19 would be exceeded by the deaths avoided by reopening the economy. that assumes we have an absolute value to avoid death. automobiles or motorcycles? because of the pleasure or what it is. we trade off for death.
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we do it all the time. smoking. why should cigarettes even be produced? we make those trade-offs all the time. some people may want to watch professional sports even if there are excess deaths as a result of covid-19. it isn't just a question of the deaths caused by shutting down the economy, it is also the pleasure forgot and how much -- forgone and how much people value that in comparison to death. host: what is your recommendation? how would you proceed? aller: dr. faust was making wrong assumption. it isn't making the kind of trade-off people make individually in terms of policy. that is not for me to choose, but that is the choice that has to be made. host: thanks for the call. dr. faust: somebody has to make
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that choice. i think the caller makes a great point. it is not inconsistent with what i wrote in the washington post. it is part of that calculation. we didn't say excess death is the only thing, we said it has to be a big part of the conversation. it reminds me of an old saying, if you do everything doctors tell you to do, you will live a long life and it will feel like a long life. as the caller says, there is a role for just enjoying life. what i am getting at with this concept he is referring to is we make these determinations all the time. whether we know it or not, we are deliberate about that. we decide to raise the speed limit 10 miles an hour for convenience or the economy or whatever reason.
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when we do that, there is a death cortland -- correlant to that. all kinds of decisions we make are constantly taking this into account. it is the way society works. i am writing about this concept too. i am thinking seriously about it. need to be that we explicit about what our parameters are. some people would say open up now because i don't care how many people die, i have to get back to life. some would say, how dare you, if even one life is lost by wanting to just enjoy living, you are essentially infringing on my right to live. this is a complicated calculation that needs to be made. my assessment is very few people
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are thinking in those terms. in a couple minutes, we will talk to a george washington university hospital dr. about the possibility of a second wave and what that would look like. with dr. jeremy faust . caller: good evening. my concern is for the children that are having problems related to the coronavirus. is could wondering this possibly be something to do with children being exposed to so many different kinds of cleaners and the protection things we are trying to use for this virus? they affect children differently. along with other illnesses, it
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could be a reaction to these cleaners. thank you. thank you. dr. faust: an important point is is the cure worse than the disease? i have not seen any evidence to suggest that is driving an uptick in pediatric mortality. the number of young people who died from this virus is thankfully very small and low. we are starting to understand more about why certain children do develop more seville air and is just -- more severe illness as we learn about why adults are becoming more ill. the ones who get sick, why? what is there risk for it? -- their risk for it?
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we don't yet really know enough on the physiological side of the virus what is happening before you factor in these environmental things, which probably have some impact, but not a great one. i don't think we are dealing with a lead paint situation where that is driving serious disease in the kids. it could go in any which direction. for all we know, keeping kids from school could be hurting them, it could be helping them. it depends on the situation. we are watching it carefully. host: bowie, maryland next. caller: why aren't i hearing more about nucleotides, the use of nucleotides to stop the replication of the virus? we all know any type of vaccine is way off. nucleotides work at the dna
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level and attack the virus at fromource to stop it replicating. why is that something we are not hearing more about? dr. faust: the way the investigational drug works, remdesivir, that we heard about last week because dr. fauci announced preliminary data that looked promising in helping patients recover more quickly. remdesivir works in the laboratory by inhibiting nucleotide growth. howry similar mechanism to many hiv medications work, that viruses reproduce by the same way our cells do. the genetic code gets copied and divides into two. when this thing is growing, this medication remdesivir is known to inhibit that in the
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laboratory. it is being looked at. he is right. the problem is that doesn't mean it works in a clinical way. if it works 20% or 90%, we have to know how many virus particles are being stopped. it could work on 95% of the viral particles it encounters, but to stop the virus from having a bad impact, you need to get to 99%. pay could be lower. we don't know yet. the trials from china show this is not saving lives in a game changing way. we are looking at it. so far the results have been incremental, not game changing. host: with the ppe doctors and nurses must have to protect themselves, how long does it take you to get ready for work?
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dr. faust: there is getting to work, then at work, then getting home. to put on andave take off the stuff. that takes a few minutes. changeu get home -- i clothes. it is an extra hassle, the extra showering and all this. to be honest, the number of covid cases in the past month was remarkable. we have never seen a virus like this before. the number of overall patients i becauseshift is down people are afraid to come in for other reasons. some people come into the er and they don't know if there shortness of breath is anxiety or a heart attack, so they need to be told what it is. we need them to feel safe to
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come in. as things returned more to normal and the number of patients gets back to usual -- going to see every patient -- i will have to assume they all have coronavirus still. it will be a hassle. i think the telehealth revolution is important. the ability to -- i can sometimes not go into a patient's room. i can see them through the glass. we are trying to increase -- to decrease our interactions. caller: you are with dr. faust in boston. good evening. go ahead. caller: nice to talk to you again. my question is about the vitamin c treatment they are using in china and south korea. oversaid the death toll there is really small compared to ours.
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host: we had a couple callers in recent weeks discussing the role of vitamin c in treating coronavirus. do you have any insight? dr. faust: i think it is early. we are seeing what is called observational or anecdotal studies. these are not randomized controlled trials where one group of patients got vitamin c or whatever and the other group got a placebo and they watched how well everyone did. i have not seen any strong evidence that that is true. we heard early on anecdotal evidence that hydroxychloroquine was supposed to be this game changing drug. as better evidence comes forward, the more we see those early signals were red herrings, at least on the level that was proffered as oh, patients take this drug and they do great. this is a virus that, if you
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really look at it, most patients recover from. it is truly under 1% once we know how many cases there are. let's say 1% of patients die, or 2% or 3%. it is very hard to find a treatment just for the small doup at risk, did that group better with treatment? many of these studies fail to do that. i would love to see something mark, but have yet to see anything compelling. host: this is the headline from the washington post, the metric that could tell us when it is safe to reemerge. dr. jeremy faust is an er physician at brigham & women's hospital in boston. also an instructor at harvard medical school. please come back again. dr. faust: thank you so much. host: a reminder our phone lines
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are open. for those out west -- for medical professionals, doctors, nurses, emts -- joining us in washington is dr. gary simon, an infectious -- the director of the infectious disease division at the george washington university school of medicine. thank you for joining us. dr. simon: nice to see you. host: you were quoted and a wall street journal piece that you worry about a second wave of covid-19. that was weeks ago. where do you stand tonight? dr. simon: i don't think that has changed. many are concerned that the second wave may be worse than the first wave. in past viral outbreaks with influenza. more recently the h1n1.
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there are more serious infections in the second wave. there are no good reasons to explain that exactly. the virus does not become more violent. perhaps the people -- more v irulent. perhaps the people in the second wave are likely to have more bad outcomes. the second wave seems to be a potential. people are getting tired of all the restrictions, of the isolation, of wearing the masks. what we are worried about is in september, if we have a second wave, it will be harder for the population to self-isolate. host: what is the challenge for public health experts to remind americans to continue to follow the protocols, the social distancing and face masks, as we move into the fall when you say a second wave could be more
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severe? dr. simon: i am sure they are all saying the same thing, specially if we see a second wave is occurring. stronglyay this more if we see what happens in those states that open up, if infections spike in those areas, in georgia and texas for example, as opposed to a state trying to maintain isolation. that would be of concern. the problem with the restrictions is people are getting very tired of them. they are getting very tired of wearing the masks, of staying at home. established social bubbles where a small group of people can get together knowing that none of them appear to be infected.
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they stay with the same group of people. that group may get larger. it is hard to maintain this isolation. it is a little shocking to see at this point. host: and look at the numbers. an increase of 62 cases in one month from february to march, then a huge spike from march to april, nearly 190,000 cases of coronavirus in the u.s. today it is 1.2 million. let's get to your phone calls. joanna is joining us from massachusetts. caller: i am concerned about this moment -- this movement of people making their own face masks out of scraps of cloth. i worked in industrial settings where they used respirators that had cartridges where the filter material could be changed. if we are in this for the long
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haul, shouldn't we be ramping up to make these safe respirators and have every person in the u.s. use them when they go out where they shop and count in the environment? i am wondering what we should do. the homemade cloth face mask is not safe. host: an infectious disease expert. masksmon: the n95 face are better than cloth face masks. i don't think cloth face masks are totally worthless. i would weather them -- rather them wear that than nothing at all. it would be better if we had everyone wear n95 masks. i think we can do the best we can with this. i think it is not possible -- unlikely we will get enough of
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the n95 masks that people needs to wear them. that would be the perfect solution, but it does not seem practical. host: our line for medical professionals is where chris is joining us from connecticut. caller: paramedic. unfortunately i lost my brother to covid. host: how long was he sick? caller: two weeks. is where he and his friends picked it up. one of his friends was fine at home. one went to the emergency room. his wife joined him in the icu and has since recovered at home. host: how old was your brother and what was his name? caller: 35. host: 35 years old. caller: he was a diabetic.
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he was overweight. that was it. every day his lungs cleared up, his fever broke. i talked to his nurse the day he passed away. she said his bloodwork looked great. host: were you able to say goodbye to him? caller: no, no. all nursing homes and health-care facilities are not allowing any visitors. icuwife was admitted to the the day before and she was able to say goodbye to him. it was a blessing in disguise. host: go ahead with your comment. our deepest sympathy for your loss. caller: i work as a paramedic in central connecticut. i am wondering if it is possible this virus might continue. we see infections in nursing homes skyrocket, where is the
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general population, it seems like the rate is coming down. is it possible it will come down and continue in nursing homes? i have seen comprehensive testing and nursing homes and whether you guys will recommend that nationwide. dr. simon: first i would like to say how sad that is about your brother, 35 years old. there are too many people dying. we are doing testing in nursing homes. we are finding high rates of infection. i think that is close contact, exposure, staff that goes from room to room, all the usual problems. you try to cohort the infected versus the noninfected. it is difficult in that kind of environment. we got a sense of the same thing, that infection rates are
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going up in nursing homes and going down in the general population, but it is too early to call. everyone is trying to "flatten the curve" so we don't have a gigantic spike like in new york. the problem with flattening the curve is it might go on for much longer. it is too early to make statements that are absolute. i hesitate to predict when this thing will be finally -- not just over, but way more down. i don't think any of us know. is going to get worse. hopefully that fear is not correct, but at this point i don't think anybody knows. host: are you still with us?
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do you want to follow up? caller: i think a lot of people want to hear answers and predictions. we have to get back to basics like handwashing and refraining from touching our hands, disinfectant. everyone wants a complicated solution. host: how is your sister in law doing? caller: good. she was advised to quarantine for 17 days. we said why don't you stay home for a few more weeks. she is looking for a job again and is doing okay. they only got married a few months ago. she is ok all things regarding. host: thank you for sharing your story. a reminder of the personal faces of this. we appreciate it. susan joins us from clarksville,
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tennessee. good evening. caller: i have a question. and i middle-aged woman take a drug for rheumatoid arthritis, which lowers your immune system. the young soldiers are just going crazy like it never even happened. everybody is just out like there is nothing else going on. it terrifies me. i run to the store and back and that is it. i'm not interested in going to the hair salon or anywhere else, but i am wondering if it did spike, how quick would we get alerted? how long does it take for a spike to actually happen? dr. simon: the spike, the hospitals would see more patients being admitted.
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you bring up an interesting question. make you more susceptible to the disease or syria's consequent is of the disease -- or the serious consequences of the disease? we don't know that. in chinese data, out of 1000 patients, they only had two that were sufficient. if it makes you more susceptible to infection, i don't have the answer. overwhelmings this inflammatory response that leads to rapid death. we are trying to treat it with things that knocked down the immune system. i don't know the answer to this. i wouldn't count on it that it susceptible to the overwhelming cytokine storms, the overwhelming immune response. i would not count on it, but i
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think it is an interesting question that has not been resolved at this point. host: for those listening on c-span radio, our guest is dr. gary simon, director of the infectious disease division at gw university's school of medicine. [phone ringing] we will let you get that phone call. caller: thank you for appearing tonight. i am a school superintendent in maine. i have grave concerns about reopening school in september. i was hoping you could share your thoughts tonight about what you would recommend to school superintendents. in the state of maine, it is a local controlled state like new hampshire. a lot of these decisions are left to me, the superintendent, in terms of the recommendation for opening schools.
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i am interested in learning your thoughts on what you would advise a school superintendent. host: what are you thinking right now? caller: right now we are thinking of a number of different options. fully if we were to reopen. we were thinking about continuing distance learning. we are thinking also about a hybrid, some distance learning and some kids come in to school on alternating days. everything is on the table. my fear is we are focused on reopening businesses right now, and that is fine, but the next wave is what do you do with schoolchildren and reopening schools? i am not getting clear and convincing evidence on how to proceed. we are left to developing contingency plans, which we have been doing since this first
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broke march 17. host: dr. simon? dr. simon: i am in the same process. i will get back to elementary and public schools. right now there is this discussion about, what about the university? are we going to have classes starting september? impression will be defined by the virus. we have to have contingency plans. ofwe have contingency plans lowering the number of students accepted, testing all the students, so on and so forth. the virus will define us. if we have a big spike in september or august, the kids can't go back to school. if it trailed off, they can. there are other possibilities. it is not either/or. kids could come in every other
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day, some amount of distanced learning. we have to all develop contingency plans. we are doing that at our university for big lectures. are we going to do it all online? will we limit it to 20 students? are students going to be masked? are we going to test students before they come in? we have to develop these plans. what we do will be defined by the virus. you have to have the same contingency plans and the will tell us what to do. host: our next collar is from baton rouge, louisiana. good evening. caller: good evening. am aestion is -- okay, i survivor of covid. of covid.vivor
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i have worked in a nursing home setting and i have seen how the spread of corona is really bad in the nursing homes. a lot of this is due to the fact that i am seeing employees are coming back before the 14 day quarantine. some employees are coming back in seven days. understanding what is the proper way. what i read from cdc is that we are not to return until we have two negative tests. host: we have the essence of the question. what doday period, and you tell those patients and employers? dr. simon: right now we are at 10 days. it depends on if you had a positive test. 1 is somewhere between 10 and
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4 days. the problem we are facing is the whole concept of two negative tests -- what does that mean? we don't know if that negative ort reflects a live virus remnants of the viral rna. it doesn't actually measure the virus itself, it measures the rna of the virus. in some people who have prolonged carriage of the virus, we are culturing them for the virus. it turns out a lot of them are culture negative. that means in some cases we are just taking up rna and not real virus and therefore they are not contagious. -- you haven days days.e at least 10
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whether that is enough, i don't think anybody knows for certain. if we keep a lot of the workforce out, we won't be able to deal with patients. we are trying to balance that. the question remains how long people are shedding viable virus. it has not been defined. shedding rna, so they are not contagious. i don't know where the line is. we expect 10 to 14 days. host: what is the looming question you get most often from your patients, from your students, from your faculty members and colleagues? dr. simon: i think we covered it. the looming question is when is this going to be over? what is going to happen?
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nobody has a definite answer. the answer we have to be prepared for his it will be -- is it will be worse. to say it will be over in the summer -- i hope it is. i hope it is gone by the end of june. every meeting i would have gone to has been canceled. a couple weddings i would have gone to have been postponed a year. that is the question. that is the looming question, how long do we have to deal with this? the worst possible scenario is we have low-level infection for two years until we get a vaccine. there are promising vaccines out there, but it is still too early to call. host: our guest is the director of the infectious disease division at george washington university, dr. gary simon. thank you for being with us.
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dr. simon: thank you. host: if you missed any part of our coverage, it is available on the web at joining us from brooklyn is a representative from new york's seventh congressional district. you clearly are at the epicenter of this pandemic. with so many issues for you and your constituents, if you had to pick one overriding issue, what would it be? hashis pandemic crystallized the structural disparities that exist in our economy and our health care system. so when we look at the numbers of those that have fell victim of the coronavirus and lost their lives, most of them are black and latino. the reality is they are the most
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vulnerable. latinos haved of access to health insurance. basically, blacks and latinos cannot work remotely. they have to show up to work in the grocery stores, in the transit system. they are the front-line workers cleaning buildings, the health care workers. a we have to reassess as nation where we are and how can theseple -- we tackle kinds of issues? at the end of the day, when it comes to a pandemic like this, it doesn't distinguish. it doesn't discriminate whether you are with health insurance or not. the fact of the matter is we
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need to put out a national strategy to deal with this pandemic. that means more testing, more tracing, isolation, and all the resources that are needed for places like new york so we can provide the health care that every human being deserves to have. host: governor andrew cuomo has been critical of washington, claiming the state is not getting nearly enough in federal assistance, especially since the majority of cases in this pandemic are coming from the new york area. how much money does the state need? how much can you guarantee washington providing? >> i don't know how much washington will be providing, but i know we have to compensate for the big expenses that the state and city government has incurred in providing the
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to those who are in need. i know the city needs $7 billion at least, and the state $14 billion. those a matter to make all areas that have been impacted whole. the federal government is to provide the resources and the leadership. this is an unprecedented crisis. it acquires an unprecedented moral commitment. that means leadership and resources. host: host: as part of your plan you
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want to make sure unemployment benefits are not taxed. but when you hear congressional republicans saying this is a blue state bailout, what is your reaction? >> there are no borders when it comes to this virus. the only thing we know about this virus is that we do not know anything about it, much about it. with this virus on day eight i was feeling well, but then i had to lay down because the pain in my body was excruciating. individual toone take a flight from new york to a red state or the other way around. there are no borders when it comes to this. we are in this together and that is the number one lesson this
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administration needs to get. host: you mentioned your own diagnosis a month and a half ago. when did you start feeling better? was day 11.ez: it himlled my doctor and told i did not have a fever. he said if i was without fever for three days, it meant i was ok. days, i after the 13 was lacking energy. recover,a long time to fully. i lost my sense of smell and and i still struggle with my sense of taste. host: having gone through that,
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are you ready to come back to washington to hold hearings and vote? rep. velazquez: yes, i am ready to go to washington, but we need to take steps necessary so we can guarantee the safety and health, not only of members of congress, of every american in this country. because wethere yet do not have the testing necessary so that we have the data that would tell us where we are in this pandemic. today tot in any place give any certainty, assurances, to the american people. i know that some people want to rush into opening the economy, but first, people have to have that assurance it is ok to walk into a restaurant, that it is ok
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to visit a retail store. they are not there yet. host: needy of alaska's represents new york's seventh district, joining us from her home in brooklyn, thank you for being with us. rep. velazquez: thank you for having me. looking at the death toll the past 60 minutes, new worldwide infections, 6516. here in the u.s. just over 2000. worldwide deaths, 268, the vast majority, 106, here in the united states. we are back tomorrow morning for another edition of the washington journal at 7:00 a.m. eastern and primetime addition tomorrow will include house speaker nancy pelosi. she will join us along with michael boston, an economist with the hoover institution. he served as the chair of economic advisers in the george h bush administration. he will be joining us from
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stanford, california. stay safe, stay healthy, we will see you tomorrow evening. ♪ [captions copyright national cable satellite corp. 2020] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit] >> c-span's washington journal live every day with news and policy issues that impact you. friday morning an infectious disease physician at the cleveland clinic discusses the latest on the u.s. response to the coronavirus pandemic and author rick atkinson talks about the 75th anniversary of ve day. watch washington journal at 7:00 eastern friday morning. join the discussion and be sure to watch washington journal
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saturday at 8:00 a.m. eastern. we are seeking answers from high schoolers across the country prepared to take u.s. history and government exams. sign up today for c-span's newsletter word for word, providing new updates to the coronavirus pandemic response from state governors, white house task force briefings and important updates from congress. sign up today, it is easy. onnect enter your email in the word for word sign up box. c-span, president trump speaking with texas governor greg abbott about the coronavirus pandemic, followed by georgia governor brian kemp providing an update to the coronavirus response in his state. and, from the national institute of health, dr. francis


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